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 ESIC Benefits

 
Medical Benefits

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Medical Benefit 
Re-entitlement

The re-entitlement can be effective in either of the following ways:

  • By Regional Office:

  • By IMO/IMP

  • On the basis of declaration of IP

By Regional Office:

A live list of IPs eligible for medical benefit in respect of every benefit  period, will be prepared on the basis of returns of contributions for the relevant contribution period. The list will be dispensary wise and will be forwarded to all the ESI dispensaries concerned before commencement of benefit period. This will facilitate enjoyment of medical benefit by eligible /needy IPs. 

By IMO/IMP:
On the basis of ESIC-37

An IP may, at time, report to the IMO/IMP for treatment and insist on getting Medical Benefit on the grounds that he is continuing in service and his contributions are being regularly deducted. Such an IP may be advised to contact his employer to obtain Form ESIC-37-certificate of re-employment/ continuing Employment. In the meanwhile, for the day, the IP/his family should be provided with necessary Medical Benefit. The IMO/IMP himself re-entitles the IP on the basis of ESIC-37 when received, for 9 months from the date indicated therein. 

On the basis of declaration of IP (ESIC-166)

If for any valid reason the IP is not able to produce ESIC-37 from his employer, in order to avoid hardship to the IP, Regional Office/LOM/IMO in service areas have been authorized to restore the Medical Benefit on the basis of a declaration to be made by the IP in Form ESIC-166. It should, however, be made clear to him that in case of his declaration being proved false, he will render himself liable to prosecution. 

The Benefit will be restored only for a period of 3 months from the date of declaration. Thereafter the IP will stand debarred from Medical Benefit automatically, unless ESIC-37, entitling the IP is received in the meantime or regular re-entry card/list is received.

   

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